{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:08:53Z","timestamp":1791828533087,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T00:00:00Z","timestamp":1642464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019219","name":"National Institute for Health Research Applied Research Collaboration South West Peninsula","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019219","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["RM\u2010SR\u20102017\u201008\u2010012"],"award-info":[{"award-number":["RM\u2010SR\u20102017\u201008\u2010012"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is growing support for a biopsy avoidant approach to diagnose coeliac disease in both children and adults, using a serological diagnosis instead.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the diagnostic accuracy of serological tests for coeliac disease in adults and children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seven electronic databases were searched between January 1990 and August 2020. Eligible diagnostic studies evaluated the accuracy of serological tests for coeliac disease against duodenal biopsy. Risk of bias assessment was performed using QUADAS\u20102. Bivariate random\u2010effects meta\u2010analyses were used to estimate serology sensitivity and specificity at the most commonly reported thresholds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>113 studies (n\u00a0=\u00a028,338) were included, all in secondary care populations. A subset of studies were included in meta\u2010analyses due to variations in diagnostic thresholds. Summary sensitivity and specificity of immunoglobulin A (IgA) anti\u2010tissue transglutaminase were 90.7% (95% confidence interval: 87.3%, 93.2%) and 87.4% (84.4%, 90.0%) in adults (5 studies) and 97.7% (91.0%, 99.4%) and 70.2% (39.3%, 89.6%) in children (6 studies); and of IgA endomysial antibodies were 88.0% (75.2%, 94.7%) and 99.6% (92.3%, 100%) in adults (5 studies) and 94.5% (88.9%, 97.3%) and 93.8% (85.2%, 97.5%) in children (5 studies).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Anti\u2010tissue transglutaminase sensitivity appears to be sufficient to rule out coeliac disease in children. The high specificity of endomysial antibody in adults supports its use to rule in coeliac disease. This evidence underpins the current development of clinical guidelines for a serological diagnosis of coeliac disease. Studies in primary care are needed to evaluate serological testing strategies in this setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16729","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T04:44:00Z","timestamp":1642567440000},"page":"514-527","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Systematic review with meta\u2010analysis: the accuracy of serological tests to support the diagnosis of coeliac disease"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1564-0740","authenticated-orcid":false,"given":"Athena L.","family":"Sheppard","sequence":"first","affiliation":[{"name":"The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust  Bristol UK"},{"name":"Population Health Sciences Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha M. C.","family":"Elwenspoek","sequence":"additional","affiliation":[{"name":"The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust  Bristol UK"},{"name":"Population Health Sciences Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren J.","family":"Scott","sequence":"additional","affiliation":[{"name":"The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust  Bristol UK"},{"name":"Population Health Sciences Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Corfield","sequence":"additional","affiliation":[{"name":"Population Health Sciences Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazel","family":"Everitt","sequence":"additional","affiliation":[{"name":"Primary Care Research Centre Faculty of Medicine University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Gillett","sequence":"additional","affiliation":[{"name":"Paediatric Gastroenterology Department Royal Hospital for Children and Young People  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair D.","family":"Hay","sequence":"additional","affiliation":[{"name":"Population Health Sciences Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayley E.","family":"Jones","sequence":"additional","affiliation":[{"name":"Population Health Sciences Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Mallett","sequence":"additional","affiliation":[{"name":"Centre for Medical Imaging University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Watson","sequence":"additional","affiliation":[{"name":"Population Health Sciences Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penny F.","family":"Whiting","sequence":"additional","affiliation":[{"name":"Population Health Sciences Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301346"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7435.322"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.55"},{"key":"e_1_2_9_5_1","volume-title":"Coeliac disease: recognition, assessment and management (NG20)","year":"2015"},{"key":"e_1_2_9_6_1","unstructured":"Conditions linked to coeliac disease.Coeliac UK.https:\/\/www.coeliac.org.uk\/information\u2010and\u2010support\/coeliac\u2010disease\/conditions\u2010linked\u2010to\u2010coeliac\u2010disease[Accessed May 2021]."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-303996"},{"key":"e_1_2_9_8_1","unstructured":"EdwardsC.BSG Interim Guidance: COVID\u201019 specific non\u2010biopsy protocol for those with suspected coeliac disease.2020.https:\/\/www.bsg.org.uk\/covid\u201019\u2010advice\/covid\u201019\u2010specific\u2010non\u2010biopsy\u2010protocol\u2010guidance\u2010for\u2010those\u2010with\u2010suspected\u2010coeliac\u2010disease[Accessed May 2021]."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.02.028"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e318216f2e5"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640613502788"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.549"},{"issue":"16","key":"e_1_2_9_13_1","first-page":"EHC032\u2010EF","article-title":"Diagnosis of celiac disease. 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